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调查自我评估与实习医生共情的患者评估之间的关系:巴西三所教学医院的一项多中心、观察性、横断面研究。

Investigating the relation between self-assessment and patients' assessments of physicians-in-training empathy: a multicentric, observational, cross-sectional study in three teaching hospitals in Brazil.

机构信息

Radiology, Pontificia Universidade Catolica de Sao Paulo Faculdade de Ciencias Medicas e da Saude, Sorocaba, São Paulo, Brazil.

CEDAR - Center for Education Development and Research in Health Professions, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

BMJ Open. 2019 Jun 25;9(6):e029356. doi: 10.1136/bmjopen-2019-029356.

Abstract

OBJECTIVES

This study investigated the associations between self-assessed empathy levels by physicians in training and empathy levels as perceived by their patients after clinical encounters. The authors also examined whether patient assessments were valid and reliable tools to measure empathy in physicians in training.

DESIGN

A multicentric, observational, cross-sectional study.

SETTING

This study was conducted in three public teaching hospitals in Brazil.

PARTICIPANTS

From the 668 patients invited to participate in this research, 566 (84.7%) agreed. Of these, 238 (42%) were male and 328 (58%) were female. From the invited 112 physicians in training, 86 (76.8%) agreed. Of the 86 physicians in training, 35 (41%) were final-year medical students and 51 (59%) were residents from clinical and surgical specialties. The gender distribution was 39 (45%) males and 47 (51%) females.

PRIMARY AND SECONDARY OUTCOME MEASURES

Physicians in training filled the Jefferson Scale of Physician Empathy (JSE) and the Interpersonal Reactivity Index. Patients answered the Jefferson Scale of Patient's Perceptions of Physician Empathy (JSPPPE) and the Consultation and Relational Empathy Scale (CARE).

RESULTS

This study found non-significant correlations between patient and physicians-in-training self-assessments, except for a weak correlation (0.241, p<0.01) between the JSPPPE score and the JSE compassionate care subscore. CARE and JSPPPE scales proved to be valid and reliable instruments.

CONCLUSIONS

Physicians-in-training self-assessments of empathy differ from patient assessments. Knowledge about empathy derived from self-assessment studies probably does not capture the perspective of the patients, who are key stakeholders in patient-centred care. Future research on the development of physician empathy or on outcomes of educational interventions to foster empathy should include patient perspectives.

摘要

目的

本研究旨在调查医学生自我评估的同理心水平与患者在临床接触后感知的同理心水平之间的关系。作者还研究了患者评估是否是衡量医学生同理心的有效和可靠工具。

设计

多中心、观察性、横断面研究。

地点

本研究在巴西的三家公立教学医院进行。

参与者

在受邀参加这项研究的 668 名患者中,有 566 名(84.7%)同意。其中,238 名(42%)为男性,328 名(58%)为女性。在受邀的 112 名医学生中,有 86 名(76.8%)同意。在这 86 名医学生中,有 35 名(41%)是医学专业的最后一年学生,51 名(59%)是来自临床和外科专业的住院医师。性别分布为 39 名(45%)男性和 47 名(51%)女性。

主要和次要结果

医学生填写了杰斐逊同理心量表(JSE)和人际反应指数。患者回答了杰斐逊患者对医生同理心感知量表(JSPPPE)和咨询与关系同理心量表(CARE)。

结果

本研究发现患者和医学生自我评估之间没有显著相关性,除了 JSPPPE 评分与 JSE 同情关怀子评分之间存在微弱相关性(0.241,p<0.01)。CARE 和 JSPPPE 量表被证明是有效的和可靠的工具。

结论

医学生自我评估的同理心与患者评估不同。自我评估研究中获得的同理心知识可能无法捕捉患者的观点,而患者是以患者为中心的护理的关键利益相关者。未来关于医生同理心发展或促进同理心的教育干预措施结果的研究应包括患者观点。

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